急性脑出血患者下丘脑垂体激素变化的研究

目的:探讨急性脑出血患者发生脑内脏综合征的高危因素。方法:以电化学发光法测定37例急性期脑出血患者、24例脑梗死患者血清卵泡刺激素(FSH)、促甲状腺激素(TSH)、促肾上腺皮质激素(ACTH)水平的变化,并与30名健康体检者作对照。分析血清FSH、TSH、ACTH水平与脑出血患者病情程度、出血量、出血是否破入脑室或是否有脑中线结构移位的相关性。结果:脑出血组和脑梗死组的血清FSH、TSH水平均较对照组为低,且脑出血组低于脑梗死组(P均<0.01);脑出血和脑梗死组的血ACTH水平均较对照组高,且脑出血组高于脑梗死组(P均<0.01)。脑出血的病情越重、出血量越大、出血破入脑室或有脑中线结构移位时,患者血清FSH、TSH水平越低,ACTH水平越高。结论:在脑出血的危急状态下,机体可能发生类似于休克时血流重新分布的神经内分泌功能重新组合。

Study on the serum concentration changes of hypothalamic-pituitary hormones of patients with acute cerebral hemorrhage

Objective: To investigate the high risk factors of occurring the syndrome of cerebral-internal organs in the patients with acute cerebral hemorrhage(ACH).Methods: The serum concentrations of follicle-stimulating hormone(FSH),thyroid-stimulating hormone(TSH) and adrenocorticotrophic hormone(ACTH) were measured by electrochemical radiation in acute period of 37 cases with ACH and 24 cases with cerebral infarction,and compared to those of the 30 healthy controls.The correlations among levels of serum FSH,TSH,ACTH and condition of illness,amount of hemorrhage,critical chamber hemorrhage and the displacement of cerebral mid-line structures were observed.Results: The levels of FSH and TSH were significantly lower,and the levels of ACTH were obviously higher in cases with ACH and cerebral infarction than those of healthy volunteers,and their changes in levels were more obvious in patients with ACH than in patients with cerebral infarction (all P<0.01).In the patients with ACH,the disease severity was severer,the hemorrhagic amount was greater.In cases with ACH,when the cerebral chamber hemorrhage and thedisplacement of cerebral midline structures occurred,the levels of FSH and TSH were more markedly low,and the level of ACTH was higher.Conclusion: The reconstitution in neuroendocrine function at critical condition of ACH is similar to the re-distribution in blood flow at shock.